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Single-fiber electromyography in myasthenia gravis

Department of Neurology, University of Virginia School of Medicine, and the University of Virginia Jerry Lewis Neuromuscular Center, Charlottesville, Virginia.

One-hundred-sixty single-fiber EMG studies of the extensor digitorum communis muscle were performed on 127 patients with myasthenia gravis; 131 demonstrated defective neuromuscular transmission. Jitter determinations in the biceps, deltoid or frontalis muscles increased the diagnostic yield significantly. Evoked-potential EMG studies were abnormal in less than 50 percent of patients in whom they were performed. The most sensitive criterion of abnormality was the percentage of fibers with increased jitter; the sensitivity of the test was enhanced, however, if the mean jitter of the tested muscle was also used as a criterion of abnormality. Since increased jitter may also be seen in primary muscle and nerve disease, these disorders must be excluded by other means before diagnosing myasthenia gravis on the basis of the single-fiber studies.

Requests for reprints should be addressed to Dr. Sanders, Department of Neurology, University of Virginia Medical Center, Charlottesville, VA 22908.

This work was supported in part by NIH Training Grant No. NS 05120–20 and the Muscular Dystrophy Association, Inc.

Presented in part at the twenty-ninth annual meeting of the American Academy of Neurology, Atlanta, Georgia, April 28 to 30, 1977.

Accepted for publication October 1, 1978.

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